微球囊压迫术和微血管减压术对三叉神经痛治疗效果评价

doi:10.19854/j.cnki.1008-2425.2024.03.0004

摘要/Abstract

摘要： 目的比较数字减影血管造影机(digital subtraction angiography,DSA)引导下微球囊压迫术和微血管减压术治疗三叉神经痛患者的效果。方法观察对象为100例2019年1月至2022年1月在我院进行治疗的三叉神经痛患者,引入随机数字表法将其分为研究组(50例)与参照组(50例),前者应用DSA引导下微球囊压迫术治疗,后者应用微血管减压术治疗。比较两组疼痛缓解率,手术前后血清白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)浓度,血清前列素E2(PGE2)浓度、血浆P物质(SP)浓度、血清降钙素基因相关肽(calcitonin gene related peptide,CGRP),过氧化物酶体增殖物激活受体γ辅激活物1-α(PGC-1α)浓度、血清5-羟色胺(5-hydroxytryptamine,5-HT)浓度、并发症发生率、随访6个月复发率。结果研究组术后24 h的疼痛缓解率,高于参照组(P＜0.05)。术后24 h,研究组的血清IL-6、TNF-α、CRP浓度,血清PGE2、血浆SP浓度,血清CGRP浓度,均低于参照组(P＜0.05)。术后24h,研究组的PGC-1α浓度、血清5-HT浓度,均高于参照组(P＜0.05)。研究组的并发症发生率、随访6个月复发率和参照组相比无差异(P＞0.05)。结论 DSA引导下微球囊压迫术治疗三叉神经痛能有效减轻疼痛,且临床操作中相对更微创。

关键词: DSA引导, 微球囊压迫术, 微血管减压术, 三叉神经痛, 并发症

Abstract: Objective To compare the effects of microballoon compression and microvascular decompression guided by digital subtraction angiography(digitalsubtractionangiography,DSA) in the treatment of trigeminal neuralgia.Methods One hundred patients with trigeminal neuralgia treated in our hospital from January 2019 to January 2022 were randomly divided into study group(n=50) and control group(n=50).The former was treated with DSA-guided microballoon compression and the latter was treated with microvascular decompression.The pain relief rates,serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),serum prostaglandin E2(PGE2),plasma substance P(SP) and serum calcitonin gene-related peptide(calcitoningenerelatedpeptide,CGRP) were compared between the two groups before and after operation.The concentration of peroxisome proliferator-activated receptor gamma coactivator 1-α(PGC-1 α) and serum 5-hydroxytryptamine(5-hydroxytryptamine),the incidence of complications and the recurrence rate after 6 months follow-up.Results The pain relief rate at 24 hours after operation in the study group was higher than that in the reference group(P＜0.05).24h after operation,the serum IL-6,TNF-α,CRP concentrations,serum PGE2,plasma SP concentrations,and serum CGRP concentrations in the study group were lower than those in the reference group(P＜0.05).24h after operation,the PGC-1α concentration and serum 5-HT concentration in the study group were higher than those in the reference group(P＜0.05).The complication rate and recurrence rate of the study group were similar to those of the reference group(P>0.05).Conclusion The DSA-guided microballoon compression in the treatment of trigeminal neuralgia can effectively reduce pain and is relatively less invasive.

Key words: DSA guidance, Microballoon compression, Microvascular decompression, Trigeminal neuralgia, Complications

中图分类号:

R745.1⁺1

赵, 鹏, 熊登喜, 查正江, 周和平, 陈敏, 张隆辉. 微球囊压迫术和微血管减压术对三叉神经痛治疗效果评价[J]. 立体定向和功能性神经外科杂志, 2024, 37(3): 146-151.

Zhao Peng, Xiong Dengxi, Zha Zhengjiang, Zhou Heping, Chen Ming, Zhang Longhui. Evaluation of microballoon compression and microvascular decompression in the treatment of trigeminal neuralgia[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2024, 37(3): 146-151.

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